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Does a 10-Item Physical Exam Add Value to Patient Care?

By Shari Welch, MD, FACEP | on February 13, 2014 | 1 Comment
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Does a 10-Item Physical Exam Add Value to Patient Care

 

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ACEP Now: Vol 33 – No 02 – February 2014

References

  1. Krogsbøll LT, Jørgensen KJ, Grønhøj Larsen C, et al. General health checks in adults for reducing morbidity and mortality from disease: Cochrane systematic review and meta-analysis. BMJ. 2012;345:e7191.
  2. Hampton JR, Harrison MJ, Mitchell JR, et al. Relative contributions of history-taking, physical examination, and laboratory investigation to diagnosis and management of medical outpatients. Br Med J. 1975;2:486-489.
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  4. Aldous SJ, Richards MA, Cullen L, et al. A new improved accelerated diagnostic protocol safely identifies low-risk patients with chest pain in the emergency department. Acad Emerg Med. 2012;19:510-516.
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  8. Meister L, Morley EJ, Scheer D, et al. History and physical examination plus laboratory testing for the diagnosis of adult female urinary tract infection. Acad Emerg Med. 2013;20:631-645.
  9. Rodriguez RM, Wang NE, Pearl RG. Prediction of poor outcome of intensive care unit patients admitted from the emergency department. Crit Care Med. 1997; 25:1801-1806.
  10. Dent AW, Weiland TJ, Vallender L, et al. Can medical admission and length of stay be accurately predicted by emergency staff, patients or relatives? Aust Health Rev. 2007;31:633-641.
  11. Kravitz RL, Cope DW, Bhrany V, et al. Internal medicine patients’ expectations for care during office visits. J Gen Intern Med. 1994;9:75-81.
  12. Bell RA, Kravitx RL, Thom D, et al. Unmet expectations for care and the patient-physician relationship. J Gen Intern Med. 2002;17:817-824.

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Topics: BillingCost of Health CareEmergency MedicineEmergency PhysicianOperationsPractice ManagementPractice TrendsProcedures and SkillsQualityReimbursement and Coding

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About the Author

Shari Welch, MD, FACEP

Shari Welch, MD, FACEP, is a practicing emergency physician with Utah Emergency Physicians and a research fellow at the Intermountain Institute for Health Care Delivery Research. She has written numerous articles and three books on ED quality, safety, and efficiency. She is a consultant with Quality Matters Consulting, and her expertise is in ED operations.

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One Response to “Does a 10-Item Physical Exam Add Value to Patient Care?”

  1. November 25, 2014

    The Land of Protocols - LITFL Reply

    […] A recent article in ACEP Now provides a particularly pernicious set of recommendations that explicitly and implicitly would lead to avoidance of much of the physical exam (only 10% yield in diagnoses – ignoring the much lower yields in ACS rule-outs and CT PE studies in low yield patients), deceiving our patients as we knowingly performing useless bedside maneuvers for show, and fabricating medical records for billing purposes. It’s one of the most disturbing articles I’ve read recently. […]

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